title: Blood lipid and lipoprotein concentrations and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition.
abstract: OBJECTIVE
  To examine the association between serum concentrations of total cholesterol, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol, triglycerides, apolipoprotein A-I (apoA), apolipoprotein B and the incidence of colorectal cancer (CRC).
  
  
  METHODS
  Nested case-control study.
  
  
  METHODS
  The study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort of more than 520,000 participants from 10 western European countries.
  
  
  METHODS
  1238 cases of incident CRC, which developed after enrolment into the cohort, were matched with 1238 controls for age, sex, centre, follow-up time, time of blood collection and fasting status.
  
  
  METHODS
  Serum concentrations were quantitatively determined by colorimetric and turbidimetric methods. Dietary and lifestyle data were obtained from questionnaires. Conditional logistic regression models were used to estimate incidence rate ratios (RRs) and 95% CIs which were adjusted for height, weight, smoking habits, physical activity, education, consumption of fruit, vegetables, meat, fish, alcohol, fibre and energy.
  
  
  RESULTS
  After adjustments, the concentrations of HDL and apoA were inversely associated with the risk of colon cancer (RR for 1 SD increase of 16.6 mg/dl in HDL and 32.0 mg/dl in apoA of 0.78 (95% CI 0.68 to 0.89) and 0.82 (95% CI 0.72 to 0.94), respectively). No association was observed with the risk of rectal cancer. Additional adjustment for biomarkers of systemic inflammation, insulin resistance and oxidative stress or exclusion of the first 2 years of follow-up did not influence the association between HDL and risk of colon cancer.
  
  
  CONCLUSIONS
  These findings show that high concentrations of serum HDL are associated with a decreased risk of colon cancer. The mechanism behind this association needs further elucidation.
authors.affiliation: Centre for Nutrition and Health, National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands. franzel.van.duijnhoven@rivm.nl
authors.forename: Fränzel J B
authors.initials: FJ
authors.lastname: van Duijnhoven
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-De-Mesquita
authors.forename: Miriam
authors.initials: M
authors.lastname: Calligaro
authors.forename: Mazda
authors.initials: M
authors.lastname: Jenab
authors.forename: Tobias
authors.initials: T
authors.lastname: Pischon
authors.forename: Eugène H J M
authors.initials: EH
authors.lastname: Jansen
authors.forename: Jiri
authors.initials: J
authors.lastname: Frohlich
authors.forename: Amir
authors.initials: A
authors.lastname: Ayyobi
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Anne Pernille
authors.initials: AP
authors.lastname: Toft-Petersen
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Louise
authors.initials: L
authors.lastname: Hansen
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cottet
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Giovanna
authors.initials: G
authors.lastname: Tagliabue
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Birgit
authors.initials: B
authors.lastname: Teucher
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Dagmar
authors.initials: D
authors.lastname: Drogan
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Pagona
authors.initials: P
authors.lastname: Lagiou
authors.forename: Vardis
authors.initials: V
authors.lastname: Dilis
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.forename: Laudina
authors.initials: L
authors.lastname: Rodríguez
authors.forename: Carlos A
authors.initials: CA
authors.lastname: González
authors.forename: Esther
authors.initials: E
authors.lastname: Molina-Montes
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: Maria-Jose
authors.initials: MJ
authors.lastname: Tormo
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: Richard
authors.initials: R
authors.lastname: Palmqvist
authors.forename: Göran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Kostas K
authors.initials: KK
authors.lastname: Tsilidis
authors.forename: Francesca L
authors.initials: FL
authors.lastname: Crowe
authors.forename: Veronique
authors.initials: V
authors.lastname: Chajes
authors.forename: Veronika
authors.initials: V
authors.lastname: Fedirko
authors.forename: Sabina
authors.initials: S
authors.lastname: Rinaldi
authors.forename: Teresa
authors.initials: T
authors.lastname: Norat
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D015992:Body Mass Index; D015179:Colorectal Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000517:prevention & control; D003124:Colorimetry; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D009749:Nutrition Surveys / Q000379:methods*; D010353:Patient Education as Topic; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D014408:Biomarkers, Tumor; D008055:Lipids; D008074:Lipoproteins